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Commission on Physician Payment Reform

The American College of Physicians Statement on National
Commission on Physician Payment Reform

Statement attributable to:
Molly Cooke, MD, FACP
President of the American College of Physicians
(ACP)

July 8, 2013

The American College of Physicians (ACP) urges Congress to
consider the recommendations of the National
Commission on Physician Payment Reform in their work to repeal
the sustainable growth rate (SGR) formula used for calculating
Medicare payments to physicians and replace it with a fair and
stable system. ACP's Executive Vice President and CEO Steven
Weinberger, MD, FACP, served as one of the Commissioners. The group
was chaired by former Robert Wood Johnson Foundation President
Steven A. Schroeder, MD, with former Senate Majority leader Bill
Frist, MD, serving as honorary chair. The group's report, released
on March 4, 2013, offers a number of recommendations aimed at
reining in health spending and improving quality of care by
fundamentally changing the way doctors are paid. Specifically, the
Commission calls for:

Abolishing the SGR.

Eliminating fee-for-service (FFS) as a stand-alone payment and
transitioning over five years to a blended payment system that will
yield better results for both public and private payers, as well as
patients.

Ensuring that measures to be used in the new payment system
will safeguard access to high quality care, are adequately
risk-adjusted, and will promote strong physician commitment to
patients.

Recognizing that FFS will remain a mode of payment in this
blended system, recalibrating FFS to encourage behavior that
improves quality and cost-effectiveness and to allow small
practices to form virtual relationships and thereby share resources
to achieve higher quality care.

The Commission also stresses that "payment reform should reward
patient-centered comprehensive care that manages transitions
between sites of care and among providers of care" and "should be
transparent to patients and the public"-points with which ACP also
strongly agrees.

The College agrees with the overall approach proposed by the
Commission, including the goal of moving away from stand-alone
fee-for-service payments. In addition, ACP recommends that all
physicians be provided stable, predictable and positive annual FFS
payment updates after the SGR is repealed for at least five years,
with higher baseline updates for undervalued evaluation and
management services, during which new models of payment and
delivery would be designed, evaluated and more broadly adopted
throughout the health care system.

"The debate over reforming Medicare physician payments is now at
a critical juncture," observed Dr. Weinberger, "with both the House
and Senate working on bipartisan bills to repeal the SGR and
transition to new approaches to paying for and delivering care,
like Patient-Centered Medical Homes. The Commission's report offers
a well-considered, evidence-based and consensus approach to reform
that should be considered by Congress as it moves forward on such
legislation."

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and medical students. Internal medicine physicians are specialists
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